Resting heart rate, temporal changes in resting heart rate, and overall and cause-specific mortality.

Seviiri, Mathias Lynch, Brigid M Hodge, Allison M Yang, Yi Liew, Danny English, Dallas R Giles, Graham G Milne, Roger L Dugué, Pierre-Antoine

REVIEW


10 April 2018

The main limitation of this study is its observational nature which limits its usefulness in terms of causality
RELEVANCE 3
INNOVATIVENESS 1
APPLICABILITY 2
OVERALL 2

PAPER DETAILS


TITLE

Resting heart rate, temporal changes in resting heart rate, and overall and cause-specific mortality.

ABSTRACT

OBJECTIVE
Most studies investigating the association between resting heart rate (RHR) and mortality have focused on cardiovascular disease (CVD) mortality, and measured RHR at only one time point. We aimed to assess associations of RHR and changes in RHR over approximately a decade with overall and cause-specific mortality.

METHODS
We used data from participants in the Melbourne Collaborative Cohort Study with RHR measures at baseline (1990-1994; n=41 386; 9846 deaths) and at follow-up (2003-2007; n=21 692; 2818 deaths). RHR measures were taken by trained staff, using Dinamap monitors. Cox models were used to estimate HR and 95% CI for the associations between RHR and mortality. Vital status and cause of death were ascertained until August 2015 and December 2013, respectively.

RESULTS
After adjustment for confounders, including blood pressure and known medical conditions but not arrhythmias or atrial fibrillation, RHR was associated with a higher risk of death of similar magnitude for CVD (HR per 10 beats per minute (bpm)=1.11, 95% CI 1.07 to 1.16), cancer (HR=1.10, 95% CI 1.06 to 1.13) and other causes (HR=1.20, 95% CI 1.16 to 1.25). Higher mortality was observed for most cancer sites, including breast (HR=1.16, 95% CI 1.03 to 1.31), colorectal (HR=1.18, 95% CI 1.08 to 1.29), kidney (HR=1.27, 95% CI 1.03 to 1.57) and lung cancer (HR=1.19, 95% CI 1.10 to 1.29). Temporal increases in RHR were associated with higher mortality, particularly for individuals whose RHR increased by more than 15 bpm.

CONCLUSIONS
RHR and changes in RHR over a decade are associated with mortality risk, including from causes other than CVD such as breast, colorectal or lung cancer. Monitoring of RHR may have utility in identifying individuals at higher mortality risk.


AUTHOR(S)

Seviiri, Mathias Lynch, Brigid M Hodge, Allison M Yang, Yi Liew, Danny English, Dallas R Giles, Graham G Milne, Roger L Dugué, Pierre-Antoine

JOURNAL

Heart (British Cardiac Society)

PLACE

England